[Nurse2bSandy]

Hi,
I hope that I get some response to this...
I am the mom of an 8yo bipolar, autistically impaired (PDD-NOS) son. He can be very aggressive and explosive. He is on numerous medications beginning at about age 4 and currently takes tenex, risperdal, celexa, buspar and most recently lithium with very little results. We have also tried about another 10 with him.
Now his ped psych doc wants to put him in the hospital so that we might take him off all meds and start from scratch. That is something that I have wanted to do for quite awhile. He is on too many meds that have not changed much, but taking him off of them to determine what might work is not something that I want to do without some isafe place, like a hospital setting.
Still, even though I know that this might be for the best for him, I am his mom and putting him in the hospital is a difficult decision. I was wondering if any of you work with ped psych and have some info for me... what kind of activities might he do, what will his schedule be like, will he just hate it there?
There are two hospital options for him... one is an actual childrens mental health facility, the other is a unit in a regular hospital. I'd like him in the children's facility, but our psych feels the better doc for him is in the reg hosp.
I need some encouragement that I am doing the right thing here...

Thanks!

[Spidey's mom]

I don't know what to tell you about the hospitals but I do have a friend whose son was on a myriad of drugs since about 1st grade. His psychiatrist said he was the most depressed and suicidal young boy he had ever seen. I'm not sure of the diagnosis but my friend decided that she needed to take him off his meds (supervised of course).

He was not hospitalized during this but it ended up being a good idea. He was so drugged before that he barely could function. That just didn't seem healthy. He is doing much better now. A really bright kid whose goal is to be very rich . . he reads financial magazines all the time. Gets good grades. Friendly. Just doesn't fit in well with his peer group but seems more content . . . . at least he is not drugged into a stupor.

I'm sorry I don't have any expertise in this area. I hope what your son is about to encounter helps.

[memphispanda]

Not a psych nurse, but a mom who can relate.

I had to hospitalize my then 6 year old...at the time his diagnosis was OCD, ADHD, major depression. Later he was reclassified as Asperger's Syndrome.

It was extremely difficult, but turned out to be one of the best choices we have made for him. He was in for 10 days, and while he wasn't close to 100% under control, he was more in control than ever before.

We chose a pediatric psych unit for him. They had children ages 3-12 there, about 6-8 kids. We chose that particular place for several reasons--the main one being the age group (the alternatives would have had him grouped with teens). I also felt more comfortable with their knowledge of psych issues and how to handle med problems he might run into. They also provided a regular classroom setting for school--they went to class for about 4 hours/day while he was there. They had intense group therapy also. He really liked being there.

Best of luck with your decision.

[memphispanda]

Oh--I should add too...my son's med list looks an awful lot like yours. He is on tenex, risperdal, celexa, and concerta. I'd like to get him off the risperdal, but every time we try to taper down he gets horrible paranoia, so we put him back up to his regular dose.

[Disablednurse]

I don't know anything about this issue, but just wanted you to know that I will have you and your son in my prayers. I hope they are able to get him on something that will help him.

[renerian]

I cannot help you either but like disablednurse I wanted you to know I hope he gets better soon. YOu must be under horrible strain.

renerian

[Nurse2bSandy]

I'd like to say that I feel better... but actually it is a feeling of very sad dread! But knowing that others have been through it or are at least thinking of and praying for us helps. It is a hard thing and makes me feel like the world's worst mother!
I know that I'm not, but I feel like he will think that we are abandoning him.
I found out since my post that his psych has arranged for him to be in the peds psych hospital... sounds like where your son was... school will happen and other kids will be his age. I am glad for that. I also would like to see him off of the risperdal... it had the best effect on him originally, but I don't know if we see a lot of difference now, although his weight has about doubled!
Thanks for the kind words... he's going in the morning...I'll keep you posted.

[Rapheal]

When your children hurt it's like a knife in your heart. I am praying for your son. Let us know his progress. I hope he comes back home soon, and is stronger and happier. Momma, you are putting your son in the hospital to help him. You are a good mother.

[susanmary]

Sending my heartfelt thoughts and prayers for you and your son. You are doing what you believe is in your son's best interest ... you know this in your heart. The facility should have a social worker that you can speak with to help you get through this emotionally difficult time. Please know that you are not alone. You are never alone ... and get into a support group if you think that will help you. I'm praying for your family ... have faith -- sometimes in life it is "one step backwards then two steps forward." Take care of yourself. Sue

[lucianne]

From my experience in pediatric psych, I think you are doing the right thing in admitting him to start his meds over again. It will be very hard on both of you--he probably will hate being in the hospital and you will feel awful for leaving him there but he needs to be in a safe place while his meds are being changed. He may get really angry with you and accuse you of not loving him. Depending on his level of developmental delay, he may not be able to understand why leaving him in the hospital is not abandonment. If he loses it when you leave him the first time (or any time after a visit), the best thing to do is to make the goodbyes short and sweet and very matter-of-fact. Letting him cling to you and trying to reassure him will only drag things out and make it more difficult. If he's upset, he's not going to hear what you say anyway.

He might actually like the hospital if he's had problems in school and with peers. Sometimes we've had kids who've made their first friends in the hospital because there are other kids there who are like them.

As far as activities, there will probably be a few hours of school every weekday. Our facility also has art therapy, group or play therapy depending on age and ability, individual therapy, family therapy, relaxation, and play time. Since your son is explosive and aggressive, you should ask (if you aren't told) about the facility's restraint and seclusion policies. Ours doesn't use mechanical restraints except in the most extreme cases and usually only with teens. For aggression or out of control behavior, we try medical restraints (prns) first, followed by seclusion with staff in attendance constantly, followed by therapeutic holding if needed for safety of the patient or others.

We allow parents to bring in special pillows or blankets from home and stuffed animals if the child is attached to them, but discourage many toys from home as these are likely to get lost or broken. Our facility doesn't allow any cords or strings longer than 6" (one set of shoes with laces) or battery-operated toys. No balloons due to suffocation risk. Photos of family taped to the wall (no frames) are nice, but be prepared that they might get destroyed in a rage.

That's all I can think of for now, if you have any questions, feel free to ask.

good luck,
luci